A global challenge posed by the presence of pharmaceuticals in the environment

(Press-News.org) Pharmaceutical products are essential for health, and they play and will continue to play a key role in disease prevention and treatment. However, they are exerting a major impact on the environment by affecting ecosystems and human health, and contributing to biodiversity loss, antimicrobial resistance and climate change. The main ingredients of medicines designed to achieve the desired health effect, together with their excipients (inert substances mixed with medicines to provide them with consistency, shape, taste, etc.) and packaging materials, are polluting the air, soil and water worldwide. This leads to problems in ecosystems, which then translate into an impact on human health.

The EHU researchers Iker Egaña and Vladimir Akhrimenko state that “the problem is very broad, with very different effects on different animal communities. Current treatment plants are not designed to remove all types of pharmaceuticals; they only manage to remove some of them. Right now, the concentrations and quantities are very small, but for a number of years now we have been seeing that they are having effects. It is a global problem. And in developing countries the situation is even worse”.

The researchers in the EHU’s Basque Sustainable Pharmacy & Biotherapy group point out that “this global problem must be addressed through global, transdisciplinary solutions, from the perspective of One Health, which encompasses both living beings and the environment. It is essential to raise awareness among all those involved in the global cycle of a medicine —from its design, production and consumption to its disposal in treatment plants— which involves the pharmaceutical, healthcare and veterinary sectors, and even the general public. The EHU researchers are proposing a set of key points designed to move forward in this regard.

Training, eco-prescription and raising awareness Egaña and Akhrimenko, among others, have conducted a critical review of initiatives already implemented and emerging ones with the aim of achieving a more sustainable pharmacy, following a full life cycle approach to identify the role of pharmacy professionals. As they point out, “to tackle the problem of pharmaceutical pollution, it is necessary to establish a sustainable pharmaceutical framework, starting with drug development and the training of future professionals”.

The solutions proposed include, for example, “the need to train future professionals in the pharmaceutical and medical sectors in the field of pharmaceutical pollution, because this is a topic currently not covered in university courses. This would help, for example, pharmaceutical companies to design more biodegradable medicines without compromising their efficacy or safety. It is important to ensure that the environmental impact analysis of a drug carries more weight”. The researchers also highlight the importance of getting involved “in advising patients regarding a more rational use of medicines, better waste management, etc.”.

The EHU researchers also suggest that environmental damage should be taken into consideration when prescribing medicines, and propose that the healthcare sector should not always go straight for the pharmacological solution, “but should also seek other types of solutions, incorporating eco-prescribing, as far as possible, into their approach. Sometimes a period of rest can be as helpful as a particular medicine,” they cite as an example. However, they believe that this is not just a health or pharmaceutical issue; “we all need to get involved and ask ourselves whether the medicine we are taking could have an environmental impact. We need to know what the consequences are of what we consume”.

European regulation The researchers pay particular attention to regulatory measures and consider that “Europe is making progress in regulation; it is reformulating a set of directives that address this issue”. The European Directive on Urban Waste Water Treatment, for example, has included the presence of pharmaceuticals and medicines as a quality indicator for the first time. They also consider the integration of extended producer responsibility into wastewater regulations to be of great importance, as this urges the pharmaceutical and cosmetics sectors to pay part of the costs of disposing of these substances in treatment plants. However, “the new drinking water regulations also mention the monitoring and measuring of the presence of pharmaceuticals for the first time”, they add. And they say that regulation is heading in the right direction.

Additional information This study falls within the framework of the PhD thesis being written up at the EHU by Iker Egaña — Head of Treatment and Quality at AMVISA (Aguas Municipales de Vitoria-Gasteiz, S.A.)—, and supervised by Gorka Orive (Professor of Pharmacy at the EHU) and Unax Lertxundi (Head of the Pharmacy Section in the Mental Araba Health Network), lead researchers in the recently set-up multidisciplinary Basque Sustainable Pharmacy & Biotherapy, group of the EHU. Vladimir Akhrimenko is a pre-doctoral researcher at the EHU.

The content of this study has been published in a prestigious journal in the field of pharmacy and aims to give the sector a wake-up call. The article could be regarded as a summary of the lines of work being pursued by the group which, although only set up recently, has members with an extensive track record in the field.

Bibliographic reference Iker Egaña, Vladimir Akhrimenko, Mirari Ayerbe, Eider Abasolo, Unax Lertxundi, Gorka Orive Promoting sustainable pharmacy for tackling environmental pharmaceutical pollution Drug Discovery Today DOI: 10.1016/j.drudis.2025.104559   END